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Testosterone and erectile function, nocturnal penile tumescence and rigidity, and erectile response to visual erotic stimuli in hypogonadal and eugonadal men.

Further evidence that nocturnal erections are androgen-dependent and erectile responses to visual erotic stimuli are androgen-independent is presented from six men with secondary hypogonadism and six eugonadal controls. Erections during sleep were substantially less in the hypogonadal men, in terms of both tumescence and rigidity. In response to visual erotic stimuli, the percentage increase in circumference over baseline and the increase in rigidity were similar for the two groups.

Adult↗

A retrospective study of relapse in rigidly fixated sagittal split osteotomies: contributing factors.

Fifty-one patients who underwent mandibular advancements with or without genioplasties were rigidly fixated with three, 2-mm bicortical screws per side. Radiographs were digitized preoperatively, immediately postoperatively, at 6 weeks, at 6 months, and at a subsequent long-term follow-up period. Location of the cephalometric landmarks, referenced to a vertical reference line (in millimeters), was used as the dependent variable. An overall inspection of the data shows that rigidly fixated mandibular advancements were very stable. The average case showed further advancement of pogonion from 6 weeks to the long-term follow-up period. However, relapse was noted in several cases. Factors that could be used as predictors of relapse were examined. Results indicated that magnitude of advancement was the only factor that successfully predicted relapse, accounting for 37.9% of the variance in the sample. Anatomic changes found to accompany such advancement are as follows: (1) when pogonion comes forward, anterior facial height and mandibular plane decrease while the proximal segment rotates forward, and (2) the maxillary central incisors flare and the mandibular incisors upright during this time period. A small degree of relapse as assessed at pogonion occurred during the first 6 weeks, followed by an advancement from 6 weeks to the longest time interval after the surgical procedure. However, these directional movements were not statistically significant.

Bone Screws↗

The effects of friction and flexural rigidity of the archwire on canine movement in sliding mechanics: a numerical simulation with a 3-dimensional finite element method.

INTRODUCTION: The purposes of this article were to clarify the combined effect of friction and an archwire's flexural rigidity on canine movement in sliding mechanics, and to explain how to select a suitable archwire and force level for efficient bodily movement. METHODS: A numerical simulation was carried out by using a 3-dimensional finite element method. RESULTS: As the frictional force decreased, both the net force acting on and the moving speed of the canine increased. The elastic deformation of the archwire increased, and the moving pattern of the canine changed from bodily movement to tipping, although there was no clearance between the archwire and the bracket slot. When a light wire was used, wire deformation increased, and the canine experienced greater tipping. These effects of friction and wire properties on canine movement (tipping and rotational angles) are combined by using a single parameter, EI/P, where EI is the flexural rigidity of the archwire, and P is the net force acting on the canine. A suitable combination of EI and P will cause canine bodily movement. The EI is determined from the archwire's size and material. CONCLUSIONS: We propose a method for estimating a suitable combination in this article.

Computer Simulation↗

Awake tracheobronchial dilation without the use of rigid bronchoscopy.

Benign tracheal strictures have been treated by repeated dilations using rigid bronchoscopy and general anesthesia. An alternative approach using conscious sedation, fluoroscopy, flexible bronchoscopy, and Savary-Gilliard esophageal dilators (Cook Endoscopy, Inc, Winston-Salem, NC) is reported. All patients undergoing dilation while awake had lesions due to inflammatory disease or lesions that were not amenable to resection. This method may be less traumatic than rigid bronchoscopy and can be accomplished on an outpatient basis without the use of general anesthesia.

Adult↗

The skeletal stability of one-piece Le Fort 1 osteotomy to advance the maxilla; Part 1. Stability resulting from non-bone grafted rigid fixation.

During the past decade, we have increasingly preferred to do a one-piece Le Fort 1 osteotomy to advance the maxilla, sometimes in isolation to treat patients with maxillary retrusive skeletal Class III patients or combined with mandibular advancement to treat bimaxillary retrusive skeletal Class II. Clinical impressions of rigid fixation techniques have indicated that there is improved stability when compared with wire fixation. There are few studies in the literature that have addressed relapse following one-piece Le Fort 1 osteotomy to advance the maxilla. Such surgery involves one single spatial movement and thereby eliminates other possible surgical variables, which may impact on the degree of stability achievable postoperatively. We studied 45 patients who had undergone a uniform one-piece maxillary advancement with elimination of controllable variables, apart from 15 patients who had simultaneous mandibular advancement. Rigid fixation was adopted throughout the study. The mean surgical change documented was 7.42 mm. The mean stability calculated at 12 months revealed a relapse of 0.72 mm (10%). This was not significant (P = 0.3). We conclude that the Le Fort 1 advancement osteotomy is a stable and surgically predictable procedure that gives only slight relapse at 12 months.

Adolescent↗

Dibasic non-imidazole histamine H3 receptor antagonists with a rigid biphenyl scaffold.

A class of rigid, dibasic, non-imidazole H3 antagonists was developed, starting from a series of previously described flexible compounds. The original polymethylene chain between two tertiary amine groups was replaced by a rigid scaffold, composed by a phenyl ring or a biphenyl fragment. Modulation of the distance between the two amine groups, and of their alkyl substituents, was driven by superposition of molecular models and docking into a receptor model, resulting in the identification of 1,1'-[biphenyl-4,4'-diylbis(methylene)]bis-piperidine (5) as a subtype-selective H3 antagonist with high binding affinity (pKi=9.47) at human H3 histamine receptor.

Animals↗

Sequence-dependent DNA torsional rigidity: a tetranucleotide code.

Using fluorescence polarization anisotropy (FPA), we measured the torsional constant of various DNA oligomers in different sequences and calculated the value for each of the 136 unique tetranucleotides. From these values, we obtained a "rigidity profile" for every double-stranded DNA sequence. We tested the code in the analysis of DNA sequences able to form nucleosomes. More than 50% of the sequences studied showed a common 20 and/or 30 bp modulation of the torsional constant. Many other profiles of rigidity were observed in the remaining sequences and this variety in torsional constant modulation may be related to functional differences between nucleosomes.

Animals↗

MULTIHYDRO and MONTEHYDRO: conformational search and Monte Carlo calculation of solution properties of rigid or flexible bead models.

A computer program, MULTIHYDRO, has been constructed for the calculation of hydrodynamic coefficients and other solution properties of multiple possible conformations of a bead model. With minimal additional programming to describe the model under study, this program interfaces efficiently with HYDRO for the calculation of solution properties, including hydrodynamic coefficients, radius of gyration, covolume, etc. A useful application is the conformation search of rigid macromolecules, because many possible conformations can be evaluated in a single run of the program. In this paper we also pay attention to the properties of flexible macromolecules, in the so-called Monte Carlo rigid-body approximation, which is virtually exact for the simpler solution properties. The theoretical aspects of the procedure are described, and we show how MULTIHYDRO can be employed for this calculation. However, for flexible molecules, a more general simulation scheme is importance-sampling Monte Carlo generation. We describe how this procedure is implemented in another computer program, MONTEHYDRO. Examples of the usage of these tools are provided.

Macromolecular Substances↗

Local rigidity of a protein molecule.

Distribution of soft and rigid substructures within a protein molecule has been implicated in several occasions and most recently from the imaging and indentation experiments using an atomic force microscope. In this paper, previously reported result of mechanical extension experiments on the recombinant bovine carbonic anhydrase II, Q253C, is re-analyzed to estimate the distribution of Young's modulus, Y, in this protein. The force vs. extension curve of the enzymatically active, type I conformer gave an estimate of Y increasing from 40 to 220 MPa as the polypeptide chain was extended from 10 to 75 nm indicating the presence of a rigid core structure. The enzymatically inactive type II, in contrast, gave an almost constant modulus of 55+/-15 MPa in the same extension range in agreement with the previous proposal that it lacked a core structure.

Animals↗

A retrospective evaluation of rigid fixation in orthognathic surgery using a biodegradable self-reinforced (70L:30DL) polylactide.

OBJECTIVE: This study was designed to evaluate clinical and radiological evidence of osteotomy site healing in orthognathic surgery after rigid fixation using a biodegradable plating system. STUDY DESIGN: A follow up of 30 patients who underwent orthognathic surgery using a biodegradable self-reinforced (70L:30DL) polylactide plating system was presented. The follow-up schedule for all patients consisted of regular appointments at 1-180 days after surgery. Clinical evaluation involved notation of any abnormal swelling, infection, discoloration, or discharge at the osteotomy sites. Stability was evaluated by manual palpation. For radiographic evaluation, panoramic radiographs were taken immediately after surgery, and again at 7-180 days. The radiographs were analyzed for any visual changes in osteotomy fragments, resorptive changes in osteotomy fragments, callus formation, and union of the osteotomy segments. RESULTS: No clinical complications and no radiological changes in the osteotomy sites were observed. Regarding the clinical usefulness of the biodegradable fixation system, fixation at the time of operation was considered as excellent in all 30 cases. CONCLUSIONS: The conclusions of this study were that self-reinforced (70L:30DL) polylactide was considered to be comparable to other forms of rigid internal fixation for orthognathic surgery.

Absorbable Implants↗

The resonance frequencies and mode shapes of dental implants: Rigid body behaviour versus bending behaviour. A numerical approach.

The purpose of this study was to evaluate the modal behaviour of the bone-implant-transducer (Osstell) system by means of finite element analyses. The influence of different parameters was determined: (1) the type of implant anchorage being trabecular, cortical, uni-cortical, or bi-cortical, (2) the implant diameter, (3) the length of the implant embedded in the bone, and (4) the bone stiffness. The type of anchorage determines the resulting modal behaviour of the implant-transducer system. A rigid body behaviour was found for a uni-cortical anchoring and for a homogeneous anchoring with low bone stiffness (< or =1000 MPa), whereas a bending behaviour was found for a homogeneous anchoring with a high bone stiffness (> or =5000 MPa) and for a bi-cortical anchorage. The implant dimensions influence the values for the resonance frequencies. Generally, an increase in implant diameter or implant length (in bone) results in higher resonance frequencies. This study also showed that resonance frequencies in case of rigid body behaviour of the implant-transducer system are more sensitive to changes in bone stiffness than resonance frequencies in case of bending behaviour. In conclusion, it seems that the Osstell transducer is suited for the follow-up in time of the stability of an implant, but not for the quantitative comparison of the stability of implants.

Anisotropy↗

Moving of a nonhomogeneous, porous floc normal to a rigid plate.

The boundary effect on the moving of a porous, nonhomogeneous, spherical floc normal to a rigid plate is analyzed theoretically for the case of low to medium Reynolds number. In particular, the drag force acting on the floc under various conditions is evaluated. A two-layer structure is adopted to simulate the nonhomogeneous nature of a floc. We show that if a floc is away from the plate, the streamlines surrounding the floc are distorted, but the degree of distortion becomes less significant if the floc is near the plate. The modified drag coefficient of a porous floc is orders of magnitude smaller than that of the corresponding rigid particle. For a fixed volume-averaged permeability, the effect of the presence of the plate on the behavior of a nonhomogeneous floc is more significant than that of a homogeneous floc, and this effect depends largely on the structure of a floc. The nonhomogeneous structure of a floc leads to a positive deviation from a Stokes-law-like correlation in the modified drag coefficient, and the smaller the volume-averaged permeability of a floc the greater the deviation. The presence of the plate has the effect of reducing this deviation. The nonhomogeneous structure of a floc on its modified drag coefficient is pronounced when it is close to a boundary.

Journal Article↗

Electrokinetic transport of rigid macroions in the thin double layer limit: a boundary element approach.

A boundary element (BE) procedure is developed to numerically calculate the electrophoretic mobility of highly charged, rigid model macroions in the thin double layer regime based on the continuum primitive model. The procedure is based on that of O'Brien (R.W. O'Brien, J. Colloid Interface Sci. 92 (1983) 204). The advantage of the present procedure over existing BE methodologies that are applicable to rigid model macroions in general (S. Allison, Macromolecules 29 (1996) 7391) is that computationally time consuming integrations over a large number of volume elements that surround the model particle are completely avoided. The procedure is tested by comparing the mobilities derived from it with independent theory of the mobility of spheres of radius a in a salt solution with Debye-Huckel screening parameter, kappa. The procedure is shown to yield accurate mobilities provided (kappa)a exceeds approximately 50. The methodology is most relevant to model macroions of mean linear dimension, L, with 1000>(kappa)L>100 and reduced absolute zeta potential (q|zeta|/k(B)T) greater than 1.0. The procedure is then applied to the compact form of high molecular weight, duplex DNA that is formed in the presence of the trivalent counterion, spermidine, under low salt conditions. For T4 DNA (166,000 base pairs), the compact form is modeled as a sphere (diameter=600 nm) and as a toroid (largest linear dimension=600 nm). In order to reconcile experimental and model mobilities, approximately 95% of the DNA phosphates must be neutralized by bound counterions. This interpretation, based on electrokinetics, is consistent with independent studies.

Journal Article↗

Capsulorhexis ovaling and capsular bag stretch after rigid and foldable intraocular lens implantation: experimental study in pediatric human eyes.

PURPOSE: To compare the amount of capsulorhexis ovaling and capsular bag stretch produced by various intraocular lenses (IOLs) implanted in pediatric human eyes obtained post-mortem. SETTING: David J. Apple, MD Laboratories for Ophthalmic Devices Research, John A. Moran Eye Center, Salt Lake City, Utah, USA. METHODS: In this nonrandomized comparative study, 16 pediatric human eyes obtained postmortem were divided into 2 groups: Eight eyes were obtained from children younger than 2 years (Group A), and 8 eyes were obtained from children older than 2 years (Group B). All eyes were prepared according to the Miyake-Apple posterior video technique. Six types of rigid and foldable posterior chamber IOLs manufactured from poly(methyl methacrylate) (single-piece), silicone (plate and loop haptics), and hydrophobic acrylic (single-piece and 3-piece AcrySof, Alcon Laboratories) biomaterials were implanted. The capsulorhexis opening and capsular bag diameters were measured before IOL implantation and after in-the-bag IOL fixation with the haptics (or the main axis) at the 3 to 9 o'clock meridian. The percentage of ovaling of the capsulorhexis opening was calculated by noting the difference in the opening's horizontal diameter before and after IOL implantation. The percentage of capsular bag stretch was also calculated by noting the difference in the horizontal capsular bag diameter before and after IOL implantation. RESULTS: All IOLs produced ovaling of the capsulorhexis opening and stretching of the capsular bag parallel to the IOL haptics. There were significant differences in capsulorhexis ovaling and capsular bag stretch (P<.001, analysis of variance) between the 6 IOL types in each group of eyes. The postimplantation difference was significant only between the single-piece hydrophobic acrylic IOL (AcrySof) and the other IOLs. The single-piece hydrophobic acrylic IOL was associated with significantly less capsulorhexis ovaling and capsular bag stretch in both groups (mean 12.06% +/- 0.59% [SD] and 7.6% +/- 1.47%, respectively). CONCLUSIONS: Modern rigid and foldable IOLs designed for the adult population implanted in the capsular bag of infants and children produced variable degrees of capsulorhexis ovaling and capsular bag stretch. The Miyake-Apple posterior video technique confirmed the well-maintained configuration of the capsular bag (with minimal ovaling) after implantation of a single-piece hydrophobic acrylic IOL because of its flexible haptic design.

Capsulorhexis↗

Predicting time to refractive stability after discontinuation of rigid contact lens wear before refractive surgery.

PURPOSE: To determine whether discontinuing rigid contact lenses for 3 weeks is sufficient to achieve refractive stability and if not, to identify factors, including indicators of corneal warpage, that are associated with prolonged corneal instability. SETTING: University-based refractive surgery practice. METHODS: Charts of patients seen for refractive surgery consultation from January 1999 to March 2001 were reviewed. Patients with a history of rigid gas-permeable (RGP) contact lens use were identified and instructed to discontinue wearing lenses 3 weeks before the initial examination. Patients were examined at 3-week intervals until a stable refraction was achieved (within +/-0.25 diopter [D] sphere and 0.25 D cylinder with less than 25 degrees of axis orientation). Visual acuity, subjective refraction, and corneal topography were obtained at each visit. RESULTS: Of 55 eyes of 28 patients, 31 eyes achieved refractive stability by the second visit (early-stability group) and 24 eyes required more than 2 visits to achieve stability (late-stability group). No statistically significant between-group difference was observed in age, sex, refractive cylinder, topographic cylinder, difference between refractive and topographic cylinders, surface regularity index, surface asymmetry index, or spherical equivalent at the initial examination. The number of years of contact lens wear was significantly different between the groups (P = .05). CONCLUSIONS: The time for contact lens-induced corneal changes to reach a steady state after cessation of lens wear is highly variable. Among the variables examined, including those indicating corneal warpage, the factor that correlated with the required time to refractive stability after discontinuation of RGP wear was the length of time of contact lens use. Patients who are long-term RGP wearers should be counseled that multiple visits will likely be required before a stable refraction is obtained.

Adult↗

Stability of skeletal class III malocclusion after combined maxillary and mandibular procedures: rigid internal fixation versus wire osteosynthesis of the mandible.

PURPOSE: The aim of this study was to evaluate skeletal stability after double-jaw surgery for correction of skeletal Class III malocclusion to assess whether there were any differences between wire and rigid fixation of the mandible. PATIENTS AND METHODS: Thirty-seven Class III patients had Le Fort I osteotomy stabilized with plate and screws for maxillary advancement. Bilateral sagittal split osteotomy for mandibular setback was stabilized with wire osteosynthesis and maxillomandibular fixation for 6 weeks in 20 patients (group 1) and with rigid internal fixation in 17 patients (group 2). Lateral cephalograms were taken before surgery, immediately after surgery, 8 weeks after surgery, and 1 year after surgery. RESULTS: Before surgery, both groups were balanced with respect to linear and angular measurements of craniofacial morphology. One year after surgery, maxillary sagittal stability was excellent in both groups, and bilateral sagittal split osteotomy accounted for most of the total horizontal relapse observed. In group 1, significant correlations were found between maxillary advancement and relapse at the posterior maxilla and between mandibular setback and postoperative counterclockwise rotation of the ramus and mandibular relapse. In group 2, significant correlations were found between mandibular setback and intraoperative clockwise rotation of the ramus and between mandibular setback and postoperative counterclockwise rotation of the ramus and mandibular relapse. No significant differences in postoperative skeletal and dental stability between groups were observed except for maxillary posterior vertical position. CONCLUSIONS: Surgical correction of Class III malocclusion after combined maxillary and mandibular procedures appears to be a fairly stable procedure independent of the type of fixation used to stabilize the mandible.

Adolescent↗

Open reduction and rigid internal fixation of mandibular condylar fractures by an intraoral approach: a long-term follow-up study of 15 patients.

PURPOSE: To evaluate the long-term results obtained with open reduction and rigid internal fixation of mandibular condylar fractures by an intraoral approach. PATIENTS AND METHODS: Fifteen patients with 24 mandibular condylar fractures were retrospectively examined with an average follow-up of 23 months (range, 6-63 months). Clinical and radiographic examination was conducted according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), including an evaluation of maximum voluntary bite force measurements and facial nerve function. Statistical analysis was performed on maximum voluntary bite force measurements and maximum pressure pain threshold. RESULTS: Two patients fulfilled the criteria for a RDC/TMD diagnosis. Myofacial pain (group I) and bilateral arthralgia (group III), combined with a moderate nonspecific physical symptom score, was diagnosed in 1 patient and 1 patient received a diagnosis of disc displacement with reduction (group II). Satisfying radiographic fracture healing was seen in 12 joints. However, miniplate fracture occurred in 3 patients and severe bone resorption of the condylar head was seen in one patient. Minor adjustment of the postoperative occlusion was necessary in 6 patients. No significant difference between maximum voluntary isometric bite force measurements or maximum pressure pain threshold was found between the fracture side and the opposite side in unilateral cases or between the operated and nonoperated side in bilateral cases. None of the patients showed facial nerve injury or visible facial scars. CONCLUSION: Within the limitations of a retrospective study, the present study emphasized that optimal management of dislocated bilateral condylar injuries combined with other fractures of the facial skeleton constitute a challenging issue in maxillofacial trauma. Moreover, open reduction and rigid internal fixation of mandibular condylar fractures by an intraoral approach is a technically demanding surgical procedure associated with a high risk of postoperative complications in these injuries.

Adolescent↗